Provider Demographics
NPI:1346058153
Name:KOL, CAMRYN
Entity type:Individual
Prefix:
First Name:CAMRYN
Middle Name:
Last Name:KOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 W PALMETTO PARK RD STE 207A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3456
Mailing Address - Country:US
Mailing Address - Phone:561-571-7557
Mailing Address - Fax:561-405-9301
Practice Address - Street 1:7301 W PALMETTO PARK RD STE 207A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3456
Practice Address - Country:US
Practice Address - Phone:561-571-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SZ12311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist